What Causes Baby Eczema—and How to Treat It
Is there anything yummier than a baby’s soft, smooth skin? Though babies are known for exactly that, picture-perfect skin isn’t always the case, and baby eczema is often to blame. Babies have extra-sensitive skin, so they’re more prone to rashes than older kids or adults. Luckily, there are baby eczema treatments that will soon get baby comfy in their own skin. Read on to learn what baby eczema is, how to spot it and how to treat it.
Baby eczema (or atopic dermatitis) appears as red or dry patches of skin, and it’s usually also itchy and rough. For babies who are predisposed to eczema, the first rashes typically appear around 2 to 4 months of age. “Baby eczema often starts as a pink, flaky rash on the cheeks and chin in young babies,” says Anna Bender, MD, a pediatric dermatologist at Weill Cornell Medicine and New York-Presbyterian in New York City. “Older babies who are of crawling age may develop the rash more on the outside of their arms and legs with dry, itchy, irritated skin patches. It may also feel rough to the touch like sandpaper.”
Is Eczema Common in Babies ?
The short answer is yes. Up to 20 percent of children in the United States may have some form of eczema, according to Bender.
It can be easy to confuse baby eczema vs. acne, since both can appear on the cheeks. But baby acne typically appears earlier in life than eczema. “Baby acne can start soon after birth, while eczema may show the first signs around 2 to 5 months of age,” says Latanya Benjamin, MD, a florida-based pediatric dermatologist and dermatologic surgeon and Society for Pediatric Dermatology board member. “Additionally, baby acne appears as classic pimples and small red pustules on the face usually with no symptoms. Eczema, on the other hand, affects both the face and body with dry or weepy red patches and is quite itchy.”
Babies with eczema might rub their face with their hands or on their parents’ clothes, or rub their legs and feet or hands together.
Eczema in babies can be divided into three categories:
- Mild baby eczema: usually appears as light pink, dry, itchy skin patches, Benjamin says, and can be treated with moisturizers alone.
- Moderate baby eczema: hot spots are redder and can affect more of the body surface, Benjamin says; they may need a cortisone cream or ointment (see below for baby eczema treatments).
- Severe baby eczema: the reddest and flakiest of all three varieties; weepy, red, rough, thickened patches that are extremely itchy and often are crusty or have deep, scabbed cuts or cracks. Severe baby eczema is usually harder to control with over-the-counter products.
Baby eczema is thought to be caused by a combination of (or, more specifically, an interplay of) genetic and environmental factors. “It occurs in families with a history of eczema, asthma and seasonal allergies,” explains Bender. “The immune system of people with eczema is more allergically prone.” What’s more, she says, the skin lacks a strong barrier to the outside world, so it can become easily irritated and dry. As a result, these babies are especially sensitive to certain factors that will incite a breakout. Different babies may be particularly vulnerable to different agents. A few common triggers of eczema in babies include:
- Dry skin (which is why eczema can be common in winter)
- Irritants (such as soaps, household detergents, wool, polyester)
- Heat and sweating
- Allergens (pet dander, pollen, dust)
- Saliva (from drooling)
Mild baby eczema may need nothing more than an over-the-counter moisturizer, but more severe cases may require treatment from your pediatrician. “The severity of the eczema dictates what the best treatment should be,” Benjamin says. “But every form of eczema demands proper skin care, including effective moisturization and itch control.” Whatever the case may be, always check in with your pediatrician if baby breaks out. Depending on the severity, your doctor may suggest some or all of these baby eczema treatment options:
• Creams. A gentle moisturizer is your first line of defense for baby eczema. “My son has eczema on his face and legs,” says one mom. “I use Aquaphor ointment on the patches for the flare-ups. Once that clears, we use regular Eucerin lotion after every bath, and his flare-ups have been really minimal.” Apply it all over baby’s body to soothe rough spots and also to improve the barrier function.
• Short baths with gentle cleansers. Proper daily skin care is crucial for keeping baby’s eczema-prone skin hydrated. Limit bath time to 15 minutes and use warm—not hot—water. Choose gentle cleansers without fragrance, and avoid harsh soaps. After the bath, pat—don’t rub—baby’s skin dry within three minutes of taking them out of the water. Finally, apply moisturizer to their whole body.
• Prescription creams and ointments. If the problem doesn’t go away, your pediatrician may suggest a prescription for a low- to medium-strength topical steroid ointment or cream, which can be used once to twice daily to help the inflammation and heal the skin. If you’re prescribed creams or ointments, it’s important to follow up with a doctor as directed to make sure it’s working properly. One mom we spoke to was given a cream that she applied four times a day on her daughter Grace, who had dry, bumpy skin all over her arms, legs, belly and back. “It went away. Then it came back about three weeks after I stopped using the cream, but not nearly as bad as the first time,” she says. “I applied the cream a few more times, and it hasn’t been back since. It’s been about three weeks now.”
• Diluted bleach baths. Inflamed skin is also more prone to infection. According to Benjamin, diluted bleach baths can not only safely manage infected eczema, but it can help minimize the use of multiple courses of oral antibiotics for kids with repeated bacterial skin infections. She suggests adding ¼ to ½ cup of regular household bleach to a full-size bathtub with 1 inch of water.
Baby Eczema Natural Remedies
Since babies have extra-sensitive skin, it’s natural to want to treat it, well, naturally. But, Bender says, “even natural products have the potential to cause a worsened rash called contact dermatitis, so check with your doctor first before applying something new to baby’s skin. Also, use only a small amount of any new product first and stick to gentle products with simple ingredient lists.” Here are a couple natural baby eczema remedies that are safe for baby:
- Coconut oil is a natural moisturizer.
- Medical grade honey for shallow cuts to prevent a local skin infection, Benjamin suggests.
- A home remedy for baby eczema is “wet wrap therapy” (also called wet pajama therapy): Bathe your child and then apply a thick moisturizer to the slightly damp skin. Dampen a pair of cotton pajamas in warm water, wring them out and slip them on baby, right over the thick layer of moisturizer. After that, put on a second dry pair of cotton pajamas. Keep baby wrapped like this for a few hours or longer.
Updated February 2020
Anna Bender, MD, is a pediatric dermatologist at Weill Cornell Medicine and New York-Presbyterian in New York City. She attended medical school at Columbia University College of Physicians and Surgeons.
Latanya Benjamin, MD, is a florida-based pediatric dermatologist and dermatologic surgeon. She also serves as a board member of the Society for Pediatric Dermatology, the only national organization in the US specifically dedicated to the field of pediatric dermatology.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.
Plus, more from The Bump: